PMID- 35103790 OWN - NLM STAT- MEDLINE DCOM- 20220228 LR - 20220228 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 5 IP - 2 DP - 2022 Feb 1 TI - Evaluation of Adiposity and Cognitive Function in Adults. PG - e2146324 LID - 10.1001/jamanetworkopen.2021.46324 [doi] LID - e2146324 AB - IMPORTANCE: Excess adipose tissue increases other cardiovascular risk factors, which may be associated with vascular brain injury and cognitive impairment. However, the extent to which the amount and distribution of adipose tissue may be associated with lower cognitive scores, independent of its association with cardiovascular risk factors, is not well characterized. OBJECTIVE: To investigate the association of adiposity on vascular brain injury and cognitive scores. DESIGN, SETTING, AND PARTICIPANTS: A total of 9189 participants from the Canadian Alliance for Healthy Hearts and Minds (CAHHM) and the Prospective Urban Rural Epidemiological-Mind (PURE-MIND) cohort studies were included in this cross-sectional analysis. Of these adults, 9166 underwent bioelectrical impedance analysis to assess body fat (BF) percentage, and 6773 underwent magnetic resonance imaging to assess vascular brain injury and measure visceral adipose tissue (VAT) volume. Participants from CAHHM were recruited from January 1, 2014, to December 31, 2018, and PURE-MIND participants were recruited from January 1, 2010, to December 31, 2018. Both CAHHM and PURE-MIND comprise multisite, population-based cohorts. Participants from CAHHM are from Canada, and PURE-MIND participants are from Canada or Poland. Data analysis was performed from May 3 to November 24, 2021. EXPOSURES: The percentage of BF and VAT were modeled as sex-specific quartiles. Vascular brain injury was defined as high white matter hyperintensities or silent brain infarction. Multivariable mixed models were used to examine factors associated with reduced cognitive scores. MAIN OUTCOMES AND MEASURES: Cognitive function was assessed using the Digital Symbol Substitution Test (DSST; scores range from 0 to 133, with lower scores indicating lower cognitive function) and Montreal Cognitive Assessment (scores range from 0 to 30, with a score of >/=26 denoting normal cognitive function). Reduced cognition was defined as a DSST score less than 1 SD below the mean. Cardiovascular risk was assessed using the INTERHEART Risk Score (IHRS; scores range from 0 to 48; low risk is defined as a score of 0 to 9, moderate risk as 10 to 16, and high risk as 17 or higher). RESULTS: A total of 9189 adults (mean [SD] age, 57.8 [8.8] years; 5179 [56.4%] women; and 1013 [11.0%] East and Southeast Asian; 295 [3.2%] South Asian; 7702 [83.8%] White European; and 179 [1.9%] other, including Black, Indigenous, mixed, and unknown ethnicity) participated in the study. Visceral adipose tissue was highly correlated with body adiposity measured by BF percentage (r = 0.76 in women; r = 0.70 in men). Cardiovascular risk factors increased with increasing BF percentage with the fourth quartile IHRS at 13.8 (95% CI, 13.5-14.0; P < .001 for trend) and with VAT with the fourth quartile IHRS at 13.3 (95% CI, 13.0-13.5; P < .001 for trend). Vascular brain injury increased with increasing BF percentage with the fourth quartile value at 8.6% (95% CI, 7.5%-9.8%; P = .007 for trend) and with increasing VAT with fourth quartile value at 7.2% (95% CI, 6.0-8.4; P = .05 for trend). Cognitive scores were lower with increasing BF percentage with the fourth quartile score of 70.9 (95% CI, 70.4-71.5; P < .001 for trend) and for VAT with the fourth quartile score of 72.8 (95% CI, 72.1-73.4; P < .001 for trend). For every 1-SD increase in BF percentage (9.2%) or VAT (36 mL), the DSST score was lower by 0.8 points (95% CI, 0.4-1.1; P < .001) for BF percentage and lower by 0.8 points (95% CI, 0.4-1.2; P < .001) for VAT, adjusted for cardiovascular risk factors and vascular brain injury. The population attributable risk for reduced DSST score for higher BF percentage was 20.5% (95% CI, 7.0%-33.2%) and for VAT was 19.6% (95% CI, 2.0%-36.0%). Higher BF percentage and VAT were not associated with Montreal Cognitive Assessment scores. CONCLUSIONS AND RELEVANCE: In this cross-sectional study, generalized and visceral adiposity were associated with reduced cognitive scores, after adjustment for cardiovascular risk factors, educational level, and vascular brain injury. These results suggest that strategies to prevent or reduce adiposity may preserve cognitive function. FAU - Anand, Sonia S AU - Anand SS AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. AD - Department of Medicine and Epidemiology, McMaster University, Hamilton, Ontario, Canada. FAU - Friedrich, Matthias G AU - Friedrich MG AD - Department of Cardiology and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada. FAU - Lee, Douglas S AU - Lee DS AD - Programming and Biostatistics, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. AD - Division of Cardiology, Peter Munk Cardiac Centre and University Health Network, University of Toronto, Toronto, Ontario, Canada. FAU - Awadalla, Phillip AU - Awadalla P AD - Department of Molecular Genetics, Ontario Institute for Cancer Research, University of Toronto, Toronto, Ontario, Canada. FAU - Despres, J P AU - Despres JP AD - Department of Kinesiology, University of Laval, Quebec City, Quebec, Canada. FAU - Desai, Dipika AU - Desai D AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - de Souza, Russell J AU - de Souza RJ AD - Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. FAU - Dummer, Trevor AU - Dummer T AD - Department of Epidemiology, Biostatistics, and Public Health Practice, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. AD - BC Cancer Agency, Vancouver, British Columbia, Canada. FAU - Parraga, Grace AU - Parraga G AD - Department of Medical Biophysics, Robarts Research Institute, Western University, London, Ontario, Canada. FAU - Larose, Eric AU - Larose E AD - Department of Medicine, University of Laval, Quebec City, Quebec, Canada. FAU - Lear, Scott A AU - Lear SA AD - Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada. FAU - Teo, Koon K AU - Teo KK AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Poirier, Paul AU - Poirier P AD - Faculte de Pharmacie, Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec City, Quebec, Canada. FAU - Schulze, Karleen M AU - Schulze KM AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Szczesniak, Dorota AU - Szczesniak D AD - Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland. FAU - Tardif, Jean-Claude AU - Tardif JC AD - Montreal Heart Institute, Universite de Montreal, Montreal, Quebec, Canada. FAU - Vena, Jennifer AU - Vena J AD - Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Edmonton, Alberta, Canada. FAU - Zatonska, Katarzyna AU - Zatonska K AD - Department of Social Medicine, Wroclaw Medical University, Wroclaw, Poland. FAU - Yusuf, Salim AU - Yusuf S AD - Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada. FAU - Smith, Eric E AU - Smith EE AD - Department of Clinical Neurosciences and Hotchkiss Brain Institute, Cumming School of Medicine, Calgary, Alberta, Canada. AD - University of Calgary, Calgary, Alberta, Canada. AD - Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Ontario, Canada. CN - Canadian Alliance of Healthy Hearts and Minds (CAHHM) and the Prospective Urban and Rural Epidemiological (PURE) Study Investigators LA - eng GR - FDN-143255/CIHR/Canada GR - FDN-143313/CIHR/Canada GR - FDN-154317/CIHR/Canada PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220201 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM MH - Adult MH - Aged MH - Canada MH - Cognition/*physiology MH - Cognitive Dysfunction/*etiology MH - Cross-Sectional Studies MH - Female MH - Humans MH - Male MH - Middle Aged MH - Obesity, Abdominal/*complications MH - Poland MH - Prospective Studies MH - Risk Assessment PMC - PMC8808326 COIS- Conflict of Interest Disclosures: Dr Anand reported receiving grants from Canadian Partnership Against Cancer, Heart and Stroke Foundation of Canada, and Canadian Institutes of Health Research, and a Canadian Institutes of Health Research Foundation grant during the conduct of the study and serving as the Tier 1 Canada Research Chair Ethnicity and Cardiovascular Disease and as the Michael G Degroote Heart and Stroke Foundation Chair in Population Helath Research, and receiving grants from Heart and Stroke Foundation of Canada and Canadian Institutes of Health Research, and receiving personal fees from Bayer outside the submitted work. Dr Friedrich reported receiving personal fees from Circle CVI Inc for serving as a board member and adviser and being a shareholder outside the submitted work. Dr Despres reported receiving grants from the Canadian Institutes of Health Research outside the submitted work. Dr de Souza reported receiving grants from the Canadian Institutes of Health Research during the conduct of the study; receiving grants from the Canadian Institutes of Health Research, Population Health Research Institute, and Hamilton Health Sciences Corporation outside the submitted work; and serving as a member of the Nutrition Science Advisory Committee to Health Canada (Government of Canada), a co-opted member of the Scientific Advisory Committee on Nutrition Subgroup on the Framework for the Evaluation of Evidence (Public Health England), and as an independent director of the Helderleigh Foundation (Canada). Dr Dummer reported receiving grants from Canadian Partnership Against Cancer during the conduct of the study. Dr Parraga reported receiving grants from the Canadian Institutes of Health Research Canadian Alliance Study during the conduct of the study and grants from Astra Zeneca and Novartis and personal fees from Astra Zeneca and Polarean outside the submitted work. Dr Lear reported receiving grants from the Canadian Institutes of Health Research and grants from Michael Smith Foundation for Health Research during the conduct of the study and personal fees from Curatio Inc outside the submitted work. Dr Szczesniak reported receiving grants from the National Science Centre during the conduct of the study. Dr Tardif reported receiving grants from Amarin, Ceapro, Esperion, Ionis, Novartis, Pfizer, RegenXBio, Sanofi, AstraZeneca, and DalCor Pharmaceuticals, receiving personal fees from AstraZeneca, HLS Pharmaceuticals, Pendopharm, and DalCor Pharmaceuticals, and having a minor equity interest in DalCor Pharmaceuticals Minor outside the submitted work. In addition, Dr Tardif had a patent for Pharmacogenomics-Guided CETP Inhibition issued by DalCor Pharmaceuticals, a patent for Use of Colchicine After Myocardial Infarction pending, and a patent for Genetic Determinants of Response to Colchicine pending. Dr Vena reported receiving grants from Alberta Health, Alberta Cancer Foundation and Canadian Partnership Against Cancer (provides program funding for Alberta's Tomorrow Project) during the conduct of the study. Dr Zatonska reported receiving grants from the National Science Center outside the submitted work. No other disclosures were reported. EDAT- 2022/02/02 06:00 MHDA- 2022/03/01 06:00 PMCR- 2022/02/01 CRDT- 2022/02/01 12:14 PHST- 2022/02/01 12:14 [entrez] PHST- 2022/02/02 06:00 [pubmed] PHST- 2022/03/01 06:00 [medline] PHST- 2022/02/01 00:00 [pmc-release] AID - 2788555 [pii] AID - zoi211278 [pii] AID - 10.1001/jamanetworkopen.2021.46324 [doi] PST - epublish SO - JAMA Netw Open. 2022 Feb 1;5(2):e2146324. doi: 10.1001/jamanetworkopen.2021.46324.